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LONGS DRUG STORES CALIFORNIA, L.L.C.
CH09047T GOLDEN VALLEY HEALTH CENTERS
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Covered Entity Details
Entity Name
GOLDEN VALLEY HEALTH CENTERS
Subdivision Name
GVHC - Riverbank
Type
HRSA-Funded Health Center
340B ID
CH09047T
Entity Address
4150 Patterson Road
Riverbank, CA 95367-2566
Grant Number
H80CS00742
Participating Start Date
10/1/2012
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03079
2224 PATTERSON RD
RIVERBANK, CA 95367
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gurjeet Sandhu, Vice President and Chief Financial Officer
(209) 384-6516
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/16/2023
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